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I work in medical administration and billing, and have for many years. This is good advice!
If you have a bill you don't think is fair, or simply can't pay, call up their billing department and tell them that. Say you can't pay this, and ask them what they can do. 9 times out of 10 they will negotiate the bill down (often by more than 50% if you keep poking), or if they're a larger hospital they might direct you to their financial relief program. For a lot of the larger hospitals applying for financial assistance can be well worth it: I make well over the median wage, yet in two different situations I applied and they wrote off my bill, accepting what insurance paid as the full amount.
The secret of medical billing is that there is very little we can do to someone who calls us up and says "I'm not going to pay", so it's worth it to negotiate you down to an amount you are willing to pay. Because otherwise we get nothing. Are there things we can do? Technically yes: we could sue you and try to get a court order to repo your stuff or garnish your wages. But that's complicated, and takes a long time, and isn't guaranteed to work: and more importantly, we get over 80% of our revenues from insurance companies anyway. Any bill a patient is getting is a small piece of the pie, and most medical billing man hours are better spent getting insurance companies to pay up. For one thing, the insurance companies actually have the money!
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